Low-cost insurance a casualty

Health Access Pueblo, an experimental health care program authorized by the Legislature to help small businesses, is closing as a result of the Affordable Care Act.

Laura Kelly

Chief Executive Officer Laura Kelly said the health plan, which currently has about 300 people enrolled through 100 participating small businesses, doesn’t meet the requirements of the new federal health care law.

“Simply put, we’re not an insurance company,” she said, noting the non-profit plan doesn’t have the financial reserves and assets required of insurance companies. “It also doesn’t meet the basic essential coverage required under the new law.”

As an example, the Affordable Care Act doesn’t allow insurance companies to “cap” a policy at a dollar amount. Kelly said Health Access Pueblo limits its hospitalization coverage to plan members at $30,000.

“Our plan also only applies to medical services within Pueblo County,” she said. Go to a Denver hospital and the plan didn’t apply.

But those limits also allowed for the plan’s very cheap prices. Qualifying businesses could let their employees enroll for $60 a month, plus a $60 contribution from the company. The plan had no deductible and low co-pays.

Kelly said the plan was watchful in requiring members to use primary care doctors and avoid emergency room care.

“Our premiums were $120 a month,” said Denise Largent, a disappointed plan member who is an office manager at Dressen Spine Center. “Now I have to look for a replacement insurance plan and they range from $600 to $1,200 a month.”

Health Access Pueblo was created and approved by state lawmakers as an experiment in helping businesses provide an affordable health plan to employees. It was allowed to operate outside state insurance supervision and regulation.

“When the plan was created back in 2007, federal health care reform wasn’t on the radar screen,” Kelly said.

The plan has served more than 650 customers over the years and more than 300 businesses.

Kelly said an important reason for its success was support from Pueblo’s two hospitals — St. Mary-Corwin Medical Center and Parkview Medical Center — which absorbed the cost of $2 million in services for plan members.

“Our members enjoyed incredible coverage for the cost, but it also had serious limitations,” she said.